RESUMO
Despite an estimated 2 million osteoporosis (OP)-related fractures annually, quality of care for post-fracture OP management remains low. This study aimed to identify patient and provider characteristics associated with achieving or not achieving optimal post-fracture OP management, as defined by the current HEDIS quality measure. The study included women 67 to 85 years of age, with ≥1 fracture, and continuous enrollment in a Humana insurance plan. The study identified a higher percentage of black women in the not achieved group (6.2% vs 5.4%; P < .0001) and Hispanic women in the achieved group (3.0% vs 1.3%; P < .0001). The not achieved group largely included patients residing in the South and urban and suburban areas. The majority of providers were primary care or OP-related specialty, and 66% did not achieve the 4-star OP rating. The study findings can guide development of predictive models to identify at-risk women to improve post-fracture OP management.
Assuntos
Osteoporose/terapia , Fraturas por Osteoporose/terapia , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Conservadores da Densidade Óssea/administração & dosagem , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Revisão da Utilização de Seguros/estatística & dados numéricos , Estilo de Vida , Aceitação pelo Paciente de Cuidados de Saúde , Grupos Raciais , Características de Residência/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Fatores SocioeconômicosRESUMO
OBJECTIVE: The undertreatment of ethnic minority children with ADHD prompted a study on the effects of methylphenidate (MPH) on the executive functions of African American children with ADHD. METHOD: Nineteen African American children with ADHD are tested on the Tower of Hanoi (TOH) and the Paired Associates Learning Task (PAL) in a double-blind crossover acute challenge of MPH and placebo. RESULTS: Under MPH, TOH rule breaks decrease, especially in the second testing session, and TOH planning time increases, particularly for incorrect solutions; PAL recall in the final learning trial improves with MPH. CONCLUSION: Similar to previous findings with predominantly majority samples of patients with ADHD, MPH enhances planning, precision, and persistence in African American children with ADHD.